Ask your AMA Guide questions to Dr. Chris Brigham. Christopher R. Brigham, MD is recognized as the nation's leading expert, author, and trainer on the Guides (www.impairment.com). We have expanded this category to include other rating questions under both new and old schedules.

Applicant sustained a right ankle injury. Her rating falls under the old PDRS. The restriction is as follows:

No running, jumping, very prolonged standing or walking such as more than 20 minutes at a time without a 3-5 minute rest, and no prolonged walking more than 2-3 blocks at a time without a 5-10 minute period of rest. Patient to use caution on uneven ground and should not have to do prolonged or repeated stair climbing.

When I first read this I thought perhaps 20% to 25% standard. Then I re-read it and the restrictions seem contradictory to me.

Part 1:<<No running, jumping, very prolonged standing or walking such as more than 20 minutes at a time without a 3-5 minute rest,>> {20% standard?}

Part 2:<<and no prolonged walking more than 2-3 blocks at a time without a 5-10 minute period of rest.>> {Suggests perhaps VERY slow walking and perhaps 30-40%? I think most people would have no problem walking 2 blocks in under 5 minutes.}

In part 1 the EE has to rest 3-5 minutes after walking 20 minutes, BUT in part 2 the EE can't walk more than 2-3 blocks and if EE does so, EE must rest 5-10 minutes. How long are these blocks and how slow does the EE walk? Perhaps window shopping? In short, the time and distance restrictions are not even close, IMHO.

In 20 minutes I can walk a lot further than 3 blocks and I think most persons could as well. Perhaps not in Amsterdam? Some of the windows there have very interesting displays!

This is a pretty clear example of a "shotgun" disability description. What was the diagnosis and mechanism of injury? Under the old rating schedule, you could search for equivalent injuries and ask would you rather have what your client has or say, a fused ankle? Although the case law forbids a WCJ from "cherry picking" to isolate some but not all factors of disability, you have a risk that the report is not substantial evidence unless the preclusions are clarified. As a quick and dirty guesstimate, I might find a 25% if the report is otherwise credible, or if not, reject the whole thing. Best wishes.